MODE OF TRANSMISSION: The mode of transmission of most cases is unknown; iatrogenic cases of CJD reported (corneal transplant, from cortical electrodes previously used on known patients, brain or eye surgery, human growth hormone therapy, exposure to infected brain tissues by pathologists), no evidence of transmission of CJD from one person to another: Kuru-handling and eating kuru infected brain during ritualistic cannibalism

INCUBATION PERIOD: Fifteen months to 2 years to CJD iatrogenic cases; 4 to over 20 years for Kuru

COMMUNICABILITY: CNS and other tissues are infectious throughout symptomatic illness; lymphoid and other organs probably infectious before signs of illness appear

SECTION III - DISSEMINATION

RESERVOIR: Human cases constitute the only known reservoir

ZOONOSIS: No documented human infections acquired from animals although this has been hypothesized (consumption of scrapie-infected sheep might result in CJD; in 1996 consumption of BSE-infected beef in UK has been associated with development of CJ-like disease)

VECTORS: None

SECTION IV - VIABILITY

DRUG SUSCEPTIBILITY: N/A

SUSCEPTIBILITY TO DISINFECTANTS: Resistance to commonly used disinfectants is well recognized: formaldehyde, glutaraldehyde, ethanol, and iodine. Immersion in undiluted bleach (60,000 ppm available chlorine) for 1 hour is only partially effective. Disinfection should be carried out using 1N sodium hydroxide at room temperature for 1 hour (shorter treatments have occasionally not inactivated the pathogen)

FIRST AID/TREATMENT: Any skin contact with infectious materials should be followed by washing with sodium hydroxide; no specific treatment

IMMUNIZATION: None

PROPHYLAXIS: None

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: No documented laboratory-associated infections with spongiform encephalopathies however, consequences of infection are grave and there are cases of infection from contaminated EEG electrodes and corneal transplants

PRIMARY HAZARDS: Accidental parenteral inoculation; risk of infection from aerosols, droplets, and exposure.of intact skin, gastric and mucous membranes is not known

SPECIAL HAZARDS: Laboratory animals that have been infected and their tissues should be considered potentially hazardous

SECTION VII - RECOMMENDED PRECAUTIONS

CONTAINMENT REQUIREMENTS: Biosafety level 3 facilities, practices and containment equipment for activities involving these agents; also listed under biosafety level 2 with special precautions; level of containment will depend on the nature of the manipulations and the amount of sera, bio/necropsy materials handled

PROTECTIVE CLOTHING: Gown and gloves when handling potentially infectious materials; eye protection may also be indicated

OTHER PRECAUTIONS: Extreme care must be taken to avoid accidental autoinoculation or other parenteral inoculations of infectious tissues and fluids

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